Omega-6支撑身体，Omega-3支撑大脑：均衡摄入对儿童大脑发育的影响（网络首发、推荐阅读）

人体大脑和身体的发育，需要从食物中摄取均衡的营养物质。人类大脑是区分人类和其他动物的特征。食物中的必需脂肪酸是机体组织结构和功能的必要组成部分。Omega-6（O6）亚油酸（LA6）是皮肤组织的组成成分，且是炎症、血栓形成、免疫和其他信号分子的前体；Omega-3（O3）α-亚麻酸（ALA3），特别是其长链代谢产物——二十二碳六烯酸（DHA3），是大脑、视网膜和部分神经组织中的关键组分。从富含LA6脂肪酸（缺乏O3脂肪酸）的植物籽中提取出的廉价而优质油脂，是20世纪的西方国家食品工业生产的主要脂肪来源。在代谢通路中，高浓度的LA6脂肪酸可拮抗O3脂肪酸代谢，造成O3脂肪酸不足，因此，在给怀孕动物的饲料中，只提供富含LA6但缺乏O3脂肪酸的油脂作为唯一的脂肪来源，会导致幼崽大脑发育不良。过去20~30年的研究表明，低含量LA6且含DHA3的油脂可改善大脑的功能。近年来的研究较多集中在营养因素对大脑发育的影响，最新研究数据表明，脂肪酸平衡对营养不良儿童的大脑发育尤为重要。世界卫生组织（WHO）越来越重视大脑的营养健康，通过其下属的食品法典委员会，建议用于治疗严重急性营养不良儿童的即食治疗食品中，使用含有均衡脂肪酸组成/构成的脂肪。同样，脂肪酸均衡对老年人可能也很重要。目前，业界已经有了调整油脂成分的方法，以确保脂肪酸均衡，从而维持人体整个生命周期的大脑健康。     

Protein–Energy Malnutrition: A Risk Factor for Various Ailments

The wheel of industrialization that spun throughout the last century resulted in urbanization coupled with modifications in lifestyles and dietary habits. However, the communities living in developing economies are facing many problems related to their diet and health. Amongst, the prevalence of nutritional problems especially protein–energy malnutrition (PEM) and micronutrients deficiencies are the rising issues. Moreover, the immunity or susceptibility to infect-parasitic diseases is also directly linked with the nutritional status of the host. Likewise, disease-related malnutrition that includes an inflammatory component is commonly observed in clinical practice thus affecting the quality of life. The PEM is treatable but early detection is a key for its appropriate management. However, controlling the menace of PEM requires an aggressive partnership between the physician and the dietitian. This review mainly attempts to describe the pathophysiology, prevalence and consequences of PEM and aims to highlight the importance of this clinical syndrome and the recent growth in our understanding of the processes behind its development. Some management strategies/remedies to overcome PEM are also the limelight of the article. In the nutshell, early recognition, prompt management, and robust follow up are critical for best outcomes in preventing and treating PEM.     

Household biomass fuel use is associated with chronic childhood malnutrition: Result from a nationwide cross-sectional survey in Bangladesh

Despite significant investment, childhood malnutrition continues to be a significant public health problem especially in least developed countries. The aim of this study was to find association between household biomass fuel (BMF) use and childhood malnutrition in Bangladesh using data from Demographic and Health Survey 2011. We included a total 6891 children under 5 years of age in the analysis. The prevalence of wasting, underweight, and stunting from BMF using household was 16.1% (n = 997; 95%CI, 15.1–17.3), 39.0% (n = 2399; 95%CI, 37.1–40.9), and 43.3% (n = 2620; 95%CI, 41.6–45.1), respectively. Underweight and stunting were significantly higher among children from households using BMF compared with the children from CF using households (underweight, biomass vs clean fuel: 39.0% vs. 23.5%, p < 0.001; stunting, biomass vs clean fuel: 43.3 vs. 31.5%, p < 0.001). The use of BMF in the household was significantly associated with underweight (OR = 1.38; 95%CI: 1.10–1.73) and stunting (OR = 1.58; 95%CI: 1.18–1.98) among children <5 years of age after adjusting possible confounders in mixed effect logistic regression analysis. This study found a significant association between chronic childhood malnutrition and household BMF use which is indicating possible alternative risk factor for malnutrition. Further prospective research is required to explore the mechanism of how BMF use results in chronic malnutrition.     

Effect of hemodiafiltration with endogenous reinfusion on overt idiopathic chronic inflammation in maintenance hemodialysis patients: A multicenter longitudinal study

Chronic inflammation is widely diffuse in maintenance hemodialysis (MHD) patients and is associated with poor survival. Hemodiafiltration with endogenous reinfusion (HFR) is a dialysis technique, highly biocompatible, able to adsorb proinflammatory cytokines and to decrease amino acids and antioxidants loss. These features could be helpful in MHD patients affected by idiopathic chronic inflammation, but this issue remains to be elucidated. We performed a multicenter longitudinal study to assess the effect of the switching from bicarbonate HD to HFR in patients with serum C‐reactive Protein (CRP) > 5 mg/L coupled with albumin <4.0 g/dL in the last 6 months. We enrolled 24/176 (14%) patients, of which 20 patients were assessed at 4 months and 18 completed the study. We excluded 11 patients with evident causes of inflammation. At baseline, serum levels of CRP (18.7[7.0–39.4] mg/L) and albumin (3.5[3.3–3.7] g/dL) were significantly correlated (r = ?0.49; P = 0.028). The effect on CRP and albumin was almost evident in the first 4 months and remained stable until to eighth month. A strict correlation (R = ?0.49; 0.040) between percentage change of CRP (?35%) and albumin (+14%) after 8 months of HFR. These effects were associated with the reduction of IL‐6, IL‐1β, and TNF‐α and the increment of pre‐albumin and leptin, whereas the serum levels of Branched Chain Amino Acid (BCAA) remained unchanged. In MHD patients affected by idiopathic chronic inflammation the switching from BHD to HFR is associated with improvement of inflammation. Whether these favorable effects may modify the outcomes of these high‐risk patients needs to be confirmed by studies ad hoc.     

The vicious cycle of vitamin a deficiency: A review

Vitamin A deficiency (VAD) is a serious and widespread public health problem and the leading cause of preventable blindness in young children. It is also associated with increased rates of death from severe infections, especially in developing countries. Over the past 35 years, researchers have examined the numerous activities of vitamin A in different tissues of the human body. VAD can lead to a series of ocular symptoms, anemia, and weak resistance to infection, which can increase the severity of infectious diseases and the risk of death. Cell development, vision, growth, and normal metabolism are among the vital processes that are insufficiently supported in the presence of VAD. VAD leads to impaired tissue function especially during the developmental periods of infancy, childhood, pregnancy, and lactation. We describe a multidirectional model of VAD that demonstrates how VAD can have progressive, negative effects on vital processes of the human body throughout the life cycle. This model starts with impaired intake and its link to decreased absorption and digestion and includes outcomes such as malnutrition, inflammation, and improper growth processes, including possible mechanisms. Together, these clinical and biochemical manifestations contribute to the vicious cycle of VAD.     

Development of a fortified peanut‐based infant formula for recovery of severely malnourished children

A peanut milk‐based infant formula was developed from peanuts. The effects of extraction pH and temperature on the yield and protein content of spray‐dried peanut milk were evaluated. Peanut‐based infant formulas (PBIF‐75) was developed using spray‐dried peanut milk and a premix of vitamins and minerals. Physical properties, approximate composition, minerals, vitamins and amino acid composition, and caloric value of PBIF‐75 were evaluated and compared to those of soya‐based infant formula (SBIF) and World Health Organization (WHO) F‐75. Spray‐dried peanut milk yield was 15–18% with a protein content of 30–45%, depending on the extraction pH and temperature. PBIF‐75 was nearly identical to WHO F‐75 in terms of amino acid profile, most vitamins and minerals, proximate composition, caloric value, and physicochemical characteristics such as water activity and colour. However, few of the vitamins and minerals in PBIF‐75 will require further adjustment to fully meet WHO’s requirements of a recovery formula for undernourished infants.     

Malted weaning food made from maize,soybean, groundnut and cooking banana

Infant malnutrition and mortality are common in Africa, although Africa is endowed with agricultural produce that could be harnessed through processing to produce adequate infant food. This project was set up to explore the possibility of using local raw materials to develop a nutritious, low‐dietary‐bulk, cheap infant food. The materials used included cereal (maize), pulses (soybean and groundnut) and tuberiferous plants (cooking banana). The grains were first germinated and dried or kilned before milling and formulation. The malted products were compared with fermented ones in terms of nutritional, dietary bulk and acceptability criteria. Malting increased the nutrient content, reduced the dietary bulk and enhanced the taste of the infant food. In terms of protein content, least gelation concentration and overall acceptability, malted samples had values in the range of 138–151 mg g^?1, 150–175 g l^?1 and 7.2–8.82 respectively, while the control (fermented) sample had values of 54 mg g^?1, 100 g l^?1 and 6.29 respectively. Roasting of malted cereals above 55 °C reduced the bulk reduction ability but enhanced the taste of the products. A combination of malted maize and soybean, roasted groundnut and cooking banana in the ratio of 50:15:15:20 gave a very recommendable weaning food for infants between the ages of 6 months and 2 years. © 2002 Society of Chemical Industry     

Oxidative stress complex syndrome: The dark side of the malnutrition‐inflammation complex syndrome

Patients undergoing maintenance hemodialysis (HD) have a high prevalence of protein‐energy malnutrition and inflammation. As these 2 conditions often occur concomitantly in HD patients, they have been referred to together as the ‘malnutrition‐inflammation complex syndrome’ (MICS) or ‘malnutrition‐inflammation atherosclerosis’ (MIA) syndrome to emphasize its important association with atherosclerotic cardiovascular disease. Oxidative stress, which results from an imbalance between oxidants and antioxidant defense mechanisms, is well established in HD subjects and could contribute to the poor clinical outcome of these patients. The aim of the present review is to discuss in more detail the common consequences of MICS and oxidative stress and their possible relationships with the long‐term complications of HD patients, leading to the conclusion that a complex syndrome similar to the MICS or MIA is the oxidative stress‐inflammation association, which may be called the “oxidative stress complex syndrome.”